Instructions for Nuclear Cardiology Stress Tests
An intravenous catheter (I.V.) will be placed in your arm. Several electrodes will
also be placed on your chest in order to record your heart rhythm (as in an EKG,
or electrocardiogram).
The first radioactive injection will be administered into the I.V. line and you will
wait 15-60 minutes before your first set of images under the camera. The first
set of images will take approximately 10-15 minutes. You will lie on a narrow
table and a special camera will rotate around your chest. It is important that you
remain very still during all of the images. (Please note that you are not
completely "inside" the camera, as you would be for an MRI.)
The next step is the stress test, which is usually conducted using a treadmill. For
this portion of the procedure you will be connected to an EKG monitor (using the
electrodes that were previously placed on your chest). A blood pressure cuff is
placed on one arm and the I.V. is in the other arm. Your blood pressure, heart
rate, and EKG rhythm are all closely monitored by the cardiologist during the
stress test. Once the desired heart rate is reached, or as directed by the
cardiologist, another radioactive injection will be administered through your I.V.
line. If at any time during the test your experience shortness of breath, dizziness,
fatigue or other discomfort, tell the cardiologist or technologist.
After the stress test portion is completed, you will have the final set of images,
which will take approximately 20 minutes. There is a delay between the
completion of the stress test and this set of images. Patients who did not walk on
the treadmill will have a longer waiting period before the final set of images.
Safety issues. Any stress test may have some risks, and you should consult
with your physician prior to the test if you have any concerns.
Radioactive injections that are used during this procedure are not dyes, and they
are not known to cause any serious side effects. Nuclear medicine tests have
been routinely performed around the world for over 30 years and are considered
to be very safe procedures.
Nuclear cardiology stress tests vs. regular stress tests. Your physician
would like to know if your heart is receiving enough blood flow, if you have
coronary artery disease (CAD), and/or if known coronary disease has progressed
in any way. The stress test can also help to determine how safe an exercise
program can be for you. Sometimes, a regular stress test may not give true
results, or may be contraindicated, for example if you have an abnormal EKG.
For these reasons, your physician may order a nuclear cardiology stress test
instead of or after a regular (exercise) stress test.
Difficulty walking on the treadmill. For patients who are unable to walk on the
treadmill, an alternative type of stress test can be performed. A medication will
be given to you either while walking slowly on the treadmill or while lying on a
stretcher. These medications are used to create the same effect as exercising,
called a pharmacologic stress test. The medications used to perform a
pharmacologic stress test are Adenosine and Dobutamine. The results of a
pharmacologic stress test are comparable to results from an exercise test
performed on a treadmill.
Patients who will, or potentially will, undergo a pharmacologic stress test must
inform the lab if they take any of the following medications, as these medications
may interfere with a pharmacologic stress test:
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Aminophylline
Aggrenox
Dipyridamole
Theodur
Theophylline
The test will take 3 to 4 hours from the time of your scheduled
appointment. You may resume your daily activities when the test is completed
and you are released by the technologist.
Preparing for the test. In order to obtain the most accurate information possible
from this test, please follow the instructions below. Call us at (240) 456-4772 or
(410) 884-3600 before deviating from these instructions.
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Please wear comfortable clothing and shoes appropriate for exercise.
No sandals, clogs, or high heel shoes (sneakers are preferred).
A short-sleeve shirt with plastic buttons or a loose t-shirt is recommended.
Turtlenecks, tight-fitting tops, or shirts with metal buttons or zippers
may NOT be worn for the test. Please do not wear perfumes, lotions, or
powders.
The lab does get cold (we need to keep the temperature low due to the
sensitive medical equipment), so please bring a sweatshirt or jacket to
wear.
Female patients who will be doing an exercise stress test on the treadmill
may prefer to wear a sports bra if you have one.
Avoid caffeine, nicotine, alcohol, and heavy sugars (cakes, cookies,
pastries, etc.) for at least 24 hours before the test. Be aware that many
decaffeinated products contain caffeine.
o Some examples of products that contain caffeine are regular and
decaffeinated coffee, hot and iced tea, some herbal teas,
sodas/soft drinks, and ALL products that are made with or contain
chocolate.
Some migraine and painkiller medications that contain caffeine
include Anacin, Excedrin, Vanquish, Fiorinal, Fioricet, and certain
stimulants/diet pills such as NoDoz and Dexatrim.
You may drink beverages such as milk or fruit juices up to 30 minutes
prior to test time (remember, do not drink any caffeinated or
decaffeinated beverages).
There is no restriction on water; you may drink water at any time.
You may eat up to 2 hours before your appointment time. This meal
may consist of anything that is not otherwise restricted above. We will
have a light snack and beverage available at the completion of your test,
or you may bring your own snack for AFTER the test.
We recommend that patients who are on insulin use half of their usual
dose at least 2 hours before coming to the lab. If you are unsure about
managing food intake and insulin dosage for this test, please call us.
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Medication instructions. Please bring an accurate list of your medications with
you to the lab on the day of the test. We need to know the names of your current
medications, and you must bring any medications that you were told not to take
before the test, as you will take them immediately after the stress test is
completed. Please review the following list for medications NOT to take,
and contact the lab if you have any concerns about NOT taking these
medications.
DO NOT take the following BETA BLOCKER medications for two days prior to
your test or the morning of your test, unless your physician gives you other
instructions:
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Acebutolol
Atenolol
Betapace
Betaxolol
Bisoprolol
Blocadren
Brevibloc
Corgard
Coreg
Esmolol
Inderal
Innopran
Kerlone
Labetalol
Levatol
Lopressor
Metoprolol
Nadolol
Pindol
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Propanolol
Sectral
Sotalol
Tenormin
Timolol
Toprol
Transdate
Visken
Zebeta
DO NOT take the following CALCIUM CHANNEL BLOCKER medications the day
before or the morning of your test.
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Adalat
Caduet
Calan
Cardene
Cardizem
Cartia
Covera
Dilacor
Dilt
Diltiazem
Dynacirc
Felodipine
Isoptin
Lexxel
Iotrel
Nicardipine
Nimotop
Norvasc
Pelndil
Procardia
Sular
Tarka
Taztia
Tiazac
Verapamil
Verelan
DO NOT take LONG ACTING NITRATES on the day of your test until the test is
completed.
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Nitro patches
Isordil
Imdur
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Isosorbide
Nitro paste
DO NOT take the following BRONCHODIALATORS on the day of your test:
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AccuNeb
Adrenalin
Advair
Albuterol
Alupent
Atrovent
Brethine
Brovana
Combivent
DuoNeb
Foradil
Ipratropium
Maxair
Metaproterenol
MicroNefrin
Perforomist
Proair
Proventil
Serevent
Spiriva
Symbicort
Terbutaline
Ventolin
Vospire
Xopenex
DO NOT take the following ANTI-ARRHYTMICS two days prior to your test and
the day of your test:
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Atropine
Betapace
Brevibloc
Cardizem
Cordarone
Covert
Epinephrine
Esmolol
Isoproterenol
Sotalol
Xylocaine
DO NOT take the following ANTIPLATELET drugs on the day of your test:
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Aggrenox
Dipyridamole
Please modify or hold ONLY the specific medications, beverages and foods
listed above. Please TAKE all other medications unless those medications
impair your ability to perform the test.
About your test results. If there are any areas of immediate concern, the
cardiologist will discuss the results of your test with you before you leave the lab,
and may also contact the physician who requested the test. A formal written
report will be sent to your physician within two business days.